Abstract Carbon dioxide sequestration and its long-term immobilisation in biomass is recently an extremely significant problem. Its greatest reserves occur in forests growing all over the globe. A human being, through their conscious action, ought to affect, among other things, the amount of carbon dioxide discharged into the atmosphere and its rational management. Here, quite a good solution seems to be the immobilisation of CO2 in biomass of plants, and in particular, in trees, characterised by their longevity, which are used most frequently for that purpose. Such carbon dioxide management allows for its several-decade immobilisation within living plants, while a further processing of wood mass allows for halting it for consecutive years in products manufactured. Additionally, in the case when within a selected land planted with trees the effluent irrigation is being carried out, simultaneous sewage treatment is also an advantage. By using plants characterised by intense increment in biomass within facilities, also biogens occurring in effluents may be effectively removed. In the analysed case, sewage treatment consisted in entry of household sewage into a prepared surface which was previously subject to mechanical purification. All the sections were sown with grass mixture and plantings of poplar were used. Observations were made during the period of 17 years. The effluents entered onto the surface of the sections and the effluents outflowing from the facility were subject to a physicochemical analysis in order to determine the operational efficiency of a plant - soil treatment system. Also, a threefold inventory of a forest stand was made in order to determine the increment in trees. The last inventory was made in 2014. Based on dendrological characteristics, the average volume of wood mass obtained from the land irrigated with effluents was assessed. A rational management of effluents on the grounds without any central drainage allows for a parallel solution to some problems. First of all, purification of effluents in a natural environment by closing the matter cycle, and additionally contributing to the limitation of carbon dioxide emission by its halting in plant biomass.


Ovarian cancer consists of many subtypes, serous carcinoma being the most common of them. In addition to the histopathological subtype, grading, clinical staging, and the amount of residual tumor, a great number of putative prognostic markers have been introduced. This study addresses in ovarian serous carcinoma the role of glycodelin, the major progesterone-regulated lipocalin protein of the reproductive axis with diverse actions in cell recognition and differentiation. Glycodelin expression was determined by immunohistochemistry of tissue microarrays in ovarian serous carcinomas from 460 patients, and the results were analyzed with respect to progesterone receptor subtype A (PRA) and progesterone receptor subtype B (PRB), clinical parameters, and survival. Glycodelin was localized to the cytoplasm of tumor cells, whereas vascular endothelium in tumor tissue was glycodelin-negative. Glycodelin expression was more frequent in well-differentiated (grade I, 79%) than in poorly differentiated carcinomas (grade III, 51%; P < 0.0001), and it was also more frequent in early-stage compared with advanced-stage carcinomas (P 0.002). Nuclear PRA and PRB were often coexpressed with cytoplasmic glycodelin. Although this was not consistent in all tumors, there was a positive correlation between the presence of glycodelin and PRs in the tumor (P < 0.02), but not between the presence of, or the absence of, glycodelin in tumor and the CA-125 serum concentration. Although in multivariate analysis glycodelin was not an independent variable, the patients with glycodelin-expressing tumors showed a higher 5-year overall survival compared with those with glycodelin-negative tumors (55 versus 39%; P < 0.0001; hazard ratio in univariate analysis, 0.57; confidence interval, 0.44–0.74). This difference was notable in patients with grade I tumors and stage III disease. In the latter group, the 10-year survival probability of patients with glycodelin-positive tumors was more than twice as high as that in women with glycodelin-negative tumors. This was also found within well-defined clinical categories, e.g., stage III/grade II and stage III/grade III carcinomas, in which patients with glycodelin-positive tumors carried significantly better 10-year overall survival compared with those with glycodelin-negative tumors. It is concluded that, in ovarian serous carcinoma, glycodelin expression portends better prognosis, probably because of its differentiation-related disposition.


Evaluating chemicals for potential in vivo toxicity based on their in vitro bioactivity profile is an important step toward animal-free testing. A compendium of reference chemicals and data describing their bioactivity on specific molecular targets, cellular pathways, and biological processes is needed to bolster confidence in the predictive value of in vitro hazard detection. Endogenous signaling by all-trans retinoic acid (ATRA) is an important pathway in developmental processes and toxicities. Employing data extraction methods and advanced literature extraction tools, we assembled a set of candidate reference chemicals with demonstrated activity on ten protein family targets in the retinoid system. The compendium was culled from Protein Data Bank, ChEMBL, ToxCast/Tox21, and the biomedical literature in PubMed. Finally, we performed a case study on one chemical in our collection, citral, an inhibitor of endogenous ATRA production, to determine whether the literature would support an adverse outcome pathway explaining the compound's developmental toxicity initiated by disruption of the retinoid pathway. We also deliver an updated Abstract Sifter tool populated with these reference compounds and complex search terms designed to query the literature for the downstream consequences to support concordance with targeted retinoid pathway disruption.


We propose that macroscopic objects built from negative-permeability metamaterials may experience resonantly enhanced magnetic force in low-frequency magnetic fields. Resonant enhancement of the time-averaged force originates from magnetostatic surface resonances (MSR) which are analogous to the electrostatic resonances of negative-permittivity particles, well known as surface plasmon resonances in optics. We generalize the classical problem of MSR of a homogeneous object to include anisotropic metamaterials, and consider the most extreme case of anisotropy where the permeability is negative in one direction but positive in the others. It is shown that deeply subwavelength objects made of such indefinite (hyperbolic) media exhibit a pronounced magnetic dipole resonance that couples strongly to uniform or weakly inhomogeneous magnetic field and provides strong enhancement of the magnetic force, enabling applications such as enhanced magnetic levitation.


Tibetans in twenty-first-century China have engaged in an increasingly high-profile campaign to promote language purity. In this purity campaign, Tibetan comedians and rappers have encouraged their audiences to speak pure Tibetan, and a host of neologisms have been coined to help people speak Tibetan even in modern contexts. Although coining new terms involves tremendous innovation, Tibetans almost uniformly view purism in this fashion as promoting traditional knowledge and practices considered to be under threat. This paper examines Tibetan media discourses on language purity to understand the development of new metadiscursive regimes in Tibet that link otherwise contemporary values like language purity with the preservation of Tibetan traditions.


This essay proposes an inversion and productive complication of the familiar nomenclature of active and passive solar energy, as it pertains to architectural design methods and to solarity more generally: that is, to changes in economies, cultures, and ways of living in the present and future. I examine three houses central to the history of solar energy and its possible futures: the George O. Löf House (Denver, CO, 1957); the Douglass Kelbaough House (Princeton, NJ, 1974), and the Saskatchewan Conservation House (Regina, Saskatchewan, 1977) in order to assess the cultural and technical changes they elicited.
 At stake in reconsidering the distinction between active and passive solar energy is an attempt to understand how we experience simultaneously the resource conditions of our thermal interiors and the transformations of global climatic patterns. Which is to say, reconsidering active and passive in solar architecture (with heat storage as the hinge) also reconsiders the role of buildings in the production of the carbon zero future—less, at least relatively, as spaces of technological innovation, and more as spaces of social and species evolution. An active passive solar architecture aspires to lifestyles, habits, and expectations coming into line with the massive geophysical transformation of climate instability. By emphasizing the contingency of the built environment and of means of inhabitation, the solar house becomes a medium for epochal social change.


The stellar velocity distribution function in the solar vicinity is reexamined using data from the Sloan Digital Sky Survey Apache Point Observatory Galactic Evolution Experiment (APOGEE) survey's DR16 and Gaia DR2. By exploiting APOGEE's ability to chemically discriminate with great reliability the thin-disk, thick-disk, and (accreted) halo populations, we can, for the first time, derive the three-dimensional velocity distribution functions (DFs) for these chemically separated populations. We employ this smaller but more data-rich APOGEE+Gaia sample to build a data-driven model of the local stellar population velocity DFs and use these as basis vectors for assessing the relative density proportions of these populations over the 5 < R < 12 kpc and −1.5 < z < 2.5 kpc range as derived from the larger, more complete (i.e., all-sky, magnitude-limited) Gaia database. We find that 81.9% ± 3.1% of the objects in the selected Gaia data set are thin-disk stars, 16.6% ± 3.2% are thick-disk stars, and 1.5% ± 0.1% belong to the Milky Way stellar halo. We also find the local thick-to-thin-disk density normalization to be ρT(R⊙)/ρt(R⊙) = 2.1% ± 0.2%, a result consistent with, but determined in a completely different way from, typical star-count/density analyses. Using the same methodology, the local halo-to-disk-density normalization is found to be ρH(R⊙)/(ρT(R⊙) + ρt(R⊙)) = 1.2% ± 0.6%, a value that may be inflated due to the chemical overlap of halo and metal-weak thick-disk stars.


Background Nivolumab combined with ipilimumab have shown activity in melanoma brain metastasis (MBM). However, in most of the clinical trials investigating immunotherapy in this subgroup, patients with symptomatic MBM and/or prior local brain radiotherapy were excluded. We studied the efficacy of nivolumab plus ipilimumab alone or in combination with local therapies regardless of treatment line in patients with asymptomatic and symptomatic MBM. Methods Patients with MBM treated with nivolumab plus ipilimumab in 23 German Skin Cancer Centers between April 2015 and October 2018 were investigated. Overall survival (OS) was evaluated by Kaplan-Meier estimator and univariate and multivariate Cox proportional hazard analyses were performed to determine prognostic factors associated with OS. Results Three hundred and eighty patients were included in this study and 31% had symptomatic MBM (60/193 with data available) at the time of start nivolumab plus ipilimumab. The median follow-up was 18 months and the 2 years and 3 years OS rates were 41% and 30%, respectively. We identified the following independently significant prognostic factors for OS: elevated serum lactate dehydrogenase and protein S100B levels, number of MBM and Eastern Cooperative Oncology Group performance status. In these patients treated with checkpoint inhibition first-line or later, in the subgroup of patients with BRAFV600-mutated melanoma we found no differences in terms of OS when receiving first-line either BRAF and MEK inhibitors or nivolumab plus ipilimumab (p=0.085). In BRAF wild-type patients treated with nivolumab plus ipilimumab in first-line or later there was also no difference in OS (p=0.996). Local therapy with stereotactic radiosurgery or surgery led to an improvement in OS compared with not receiving local therapy (p=0.009), regardless of the timepoint of the local therapy. Receiving combined immunotherapy for MBM in first-line or at a later time point made no difference in terms of OS in this study population (p=0.119). Conclusion Immunotherapy with nivolumab plus ipilimumab, particularly in combination with stereotactic radiosurgery or surgery improves OS in asymptomatic and symptomatic MBM.


This research investigated what the term Quality Physical Education (QPE) meant to Health and Physical Education (HPE) teachers in Australian Capital Territory (ACT) schools. A total of 14 HPE teachers who taught middle school or above, representing government and independent schools, took part in focus group interviews about their understanding of QPE and the factors that influenced their constructs. Figurational sociology and the concepts of interdependence, habitus, and involvement and detachment, were used to inform the research and interpret the findings. It was found that teachers' accounts of QPE were largely informed by their individual and collective experiences and their personal 'philosophies' of physical education. With the exception of a recently introduced national curriculum for HPE, the teachers in this study did not use, or refer to, any evidence-based documents in forming their ideas about QPE. Further, they did not mention any recognised pedagogical approaches that they used in teaching QPE. The findings from this research are important, because 'everyday' or common-sense teacher understandings can negatively impact student learning and threaten the status and credibility of our profession.


The connectivity of devices, machines and people via Cloud infrastructure can support collaborations among doctors and specialists from different medical organisations. Such collaborations may lead to data sharing and joint tasks and activities. Hence, the collaborating organisations are responsible for managing and protecting data they share. Therefore, they should define a set of access control policies regulating the exchange of data they own. However, existing Cloud services do not offer tools to analyse these policies. In this paper, we propose a Cloud Policy Verification Service (CPVS) for the analysis and the verification of access control policies specified using XACML. The analysis process detects anomalies at two policy levels: a) intra-policy: detects discrepancies between rules within a single security policy (conflicting rules and redundancies), and b) inter-policies: detects anomalies between several security policies such as inconsistency and similarity. The verification process consists in verifying the completeness property which guarantees that each access request is either accepted or denied by the access control policy. In order to demonstrate the efficiency of our method, we also provide the time and space complexities. Finally, we present the implementation of our method and demonstrate how efficiently our approach can detect policy anomalies.


This paper presents a two-axis electrothermal single-crystal-silicon micromirror that is tilted 45° out of plane on a silicon optical bench (SiOB). The SiOB provides mechanical support and electrical wiring to the tilted two-axis scanning mirror, as well as aligned trenches for assembling other optical components, such as optical fibers and GRIN lens. The preset tilting of the mirror plate is achieved via the bending of a set of stressed bimorph cantilevers. A stopper connected on the bending bimorphs reaches and is stopped by the adjacent silicon sidewall. The tilt angle can be precisely controlled by properly choosing the distance from the stopper to the silicon sidewall and the flexure bimorph length. The fabricated mirror plate is 0.72 mm × 0.72 mm and the footprint of the entire MEMS device is 2.22 mm × 1.25 mm. The measured maximum total optical scan angle of the mirror is approximately 40° in both x-axis and y-axis at only 5.5 Vdc. This technology will enable a new class of more compact microendoscopic optical imaging probes for in vivo early cancer detection.


Naval Petroleum Reserve No. 3 (NPR-3), better known as the Teapot Dome oil field, is the last United States federally owned and operated oil field. This gives us a unique opportunity for experiments to provide scientific and technical insight into CO2-enhanced oil recovery and other topics involving subsurface fluid behavior. Toward that end, a combination of federal, academic, and industrial support has produced outstanding characterizations of important oil- and brine-bearing reservoirs there. This effort provides an unparalleled opportunity for industry and others to use the site. Data sets include geological, geophysical, geochemical, geomechanical, and operational data across a wide range of geological boundary conditions. Importantly, these data, many in digital form, are available in the public domain because of NPR-3's federal status. Many institutions are already using parts of the Teapot Dome data set as the basis for a variety of geoscience, modeling, and other research efforts. Fifteen units, nine oil bearing and six brine bearing, have been studied to varying degrees. More than 1200 wells in the field are active or accessible, and more than 400 of these penetrate 11 formations located below the depth that corresponds to the supercritical point for CO2. Studies include siliciclastic and carbonate reservoirs; shale, carbonate, and anhydrite cap rocks; fractured and unfractured units; and overpressured and underpressured zones. Geophysical data include three-dimensional (3-D) seismic and vertical seismic profiles. Reservoir data include stratigraphic, sedimentological, petrologic, petrographic, porosity, and permeability data. These have served as the basis for preliminary 3-D flow simulations. Geomechanical data include fractures (natural and drilling induced), in-situ stress determination, pressure, and production history. Geochemical data include soil gas, noble gas, and hydrocarbon organic geochemistry. The conditions of these reservoirs directly or indirectly represent many reservoirs in the United States, Canada, and overseas.


Wireless sensor networks are composed of large number of power constrained nodes, which needs an energy conservation protocols to reduce the energy consumption as much as possible. Utilizing clustering algorithms is a common method of implementing network management and data aggregation in WSNs. This paper presents a review on the clustering algorithms proposed for wireless sensor networks.


From the last few decades, maximum studies focused to understand the importance of going into the deal of Mergers & Acquisitions (M&A). The current study examined the motivation to recognize either the assumed benefits of the deal of Mergers and Acquisitions have posted increase or not. The current study calculated whether the deal is beneficial or harmful for the organizations who want to enter into the deal of M&A. The study scrutinizes the issues by using the perspective of history, waves, motives and methods to determine Merger and acquisition value. The study focuses on the current Literature available on M&A from the recent past to portray unlike the methods used to gauge performance of M&A. Although field of M&A research is far too broad and more complex to be covered in a review paper, therefore, the study attempts to start covering some historical and background issues such as History, waves in M&A, Methods of measuring deals and M&A motives.


Rice is one of the most popular staple foods produced contributing higher most in agriculture gross domestic production in Nepal. Thus, nutritional, physicochemical, and cooking properties of rice might interplay important roles in their production and farming practice, therefore, it is inevitable to understand these characteristic features. However, there has been only limited information available on such properties, therefore we aimed to examine nutritional, physicochemical and cooking properties of four Basmati varieties of rice namely Red Basmati, White Basmati, Black Basmati and Pokhareli Basmati. These rice varieties were purchased from different places in Nepal in paddy form. In this study various parameters associated with milling, nutritional, physical and cooking properties were evaluated. To measure protein contents in rice, Kjeldal method was implied. Among the varieties, the protein content was maximum in Red Basmati (7.74%) and minimum in Black Basmati (6.51%). The milled rice percentage and head rice recovery were maximum in Pokhareli Basmati represented by 72.02±0.10 and 67.46±0.42, respectively, while and minimum in White Basmati represented by 68.17±0.50 and 65.11±0.28, respectively. The kernel elongation ratio and volume expansion ratio was maximum in Red Basmati represented by 1.62 and 2.85 respectively. Water uptake ratio was maximum 3.11 in Black Basmati and minimum of 2.18 in Red Basmati. Gruel loss was found lowest 1.05% in Red Basmati and highest represented by 2.40% in Black Basmati. The highest starch iodine blue value of 0.21 was observed in Red Basmati and lowest of 0.12 in Black Basmati. The Red Basmati was found to have the better cooking quality among all varieties.


Qur'an 4:34, interpreted literally, suggests that some form of beating is an appropriate punishment for a husband to administer to a disobedient wife. In this essay, we demonstrate that from the moment of its revelation, many Muslims including (according to tradition) the Prophet Muhammad himself have struggled to reconcile this verse with their consciences. In contemporary discourse, there have emerged two strands of interpretation, building on premodern interpretations: one traditionalist, which allows for limited violence against wives, and one reformist, which reinterprets the verse to argue that its intention was not to allow the beating of wives. Jurists have grappled with this verse, seeking to define and regulate its proper implementation in actual disputes between husbands and wives. In this essay, the authors identify a debate within the legal tradition (fiqh) that parallels that among Qur'anic interpreters, as premodern and contemporary legal scholars argue for and against the use of individual reason (ijtihad) or conscience in their rulings dealing with the role and status of women. Finally, they identify promising directions for future research on this issue, particularly in regard to contemporary Western democracies where Muslims are a minority.


This paper describes how the European Rail Traffic Management System (ERTMS) is the concept by which Europe is moving towards the standardization of its rail signal control systems. Standardization focuses on interfaces necessary for interoperability between trainborne and trackside equipment. ERTMS represents a step change for many railways', the vast majority of which are signaled with color light signals and basic warning systems. ERTMS is specified in a number of different levels, and dependant on the implementation can introduce the benefits of cab signaling, automatic train protection and future moving block train separation. This paper examines the capabilities and limitations of an ETCS/ERTMS level 2 implementation as specified by the current Technical Specifications for Interoperability for use in high density network locations and the suitability of ETCS/ERTMS to support the integration of an Automatic Train Operation (ATO) overlay. A generic sample section has been developed to analyze the headway constraints within the current ERTMS solution. The conclusions from the study suggest that there are no fundamental constraints preventing a level 2 implementation supporting an operational headway of 24 Trains Per Hour with recovery margin. The use of ATO for a high density application will offer an improved headway performance but will require a level of development and enhancement to the ERTMS functionality and architecture to correctly implement some ATO functionality. A further potential constraint is the capacity of the GSM-R radio communication network. This limitation can be removed by the envisaged migration to packet mode (GPRS) data transmission.


The kinetics of reversible complex formation of NiII, CoIIand CuII with the pentaammine-(nitrilotriacetato)cobalt(III) ion, [Co(NH3)5(H2nta)]2+(H3nta = nitrilotriacetic acid) have been investigated at 0.0025 ⩽[M2+]⩽ 0.04, 0.004 ⩽[H+]⩽ 0.05 mol dm–3, 10.0 ⩽T⩽ 40.0 °C and I= 0.3 mol dm–3. The rate constants for the formation of the binuclear species are at least 103 times less than the water exchange rate constants of [M(OH2)6]2+ under comparable conditions. General base catalysis indicated that proton transfer from the NH+ site of the co-ordinated ligand (nta) is involved in the rate determining step. The binuclear species undergo dissociation via spontaneous and acid-catalysed paths. The low values of spontaneous dissociation rate constants also support the chelate nature of the binuclear species. It is likely that the nta moiety of (NH3)5Co(nta) acts at least as a tridentate ligand and the chelate ring closure/opening via N–MII bond formation/dissociation is rate limiting. Complex formation with FeIII and AlIII has been investigated at 15–35 °C (I= 1.0 mol dm–3) and 25 °C (I= 0.3 mol dm–3), respectively. General base catalysis was not observed for these trivalent metal ions. The [M(OH2)5(OH)]2+ species reacted faster than [M(OH2)6]3+. The reaction of [M(OH2)6]3+ may involve an associative interchange mechanism while that for [M(OH2)5(OH)]2+ involves dissociative interchange.


The objective of this work is to analyze the intrinsic aspects for policy dimension inside the energy planning and energy long term sustainability. In that sense, the methodology intends to take the Brazilian example as a case study and offer a somewhat unorthodox perspective on the subject of State energy planning. This matter is, beyond a purely technical question or a problem for the field of exact sciences, a point of primary interest to the field of social and human sciences. More the backbone methodology in this research is the Integrated Energy-Resources Planning (IRP), chosen for its ability to integrate both the supply and demand perspectives in the discussions about energy planning [1] [2]. A historical perspective is a guideline to approach issue: starting at the early Twentieth century, this study covers the major landmarks of the country energy concern to the present day; particularly noteworthy are the implications of the realpolitik—that is, the elements in politics that are developed within the institutional frameworks, such as governmental plans and decisions. As a result, it presents a complex picture, which we try to understand from the perspective of supply and demand integration. The originality of the study lies in the refusal to accept fallacious technical statements, as we consider the issue primarily a human and social problem, but considering the validity of technical statements that are correct.


Immunology is indeed, as Prof. Boyd writes in his first chapter, " a very practical science, concerned with methods of preventing disease or influencing its course," but it touches clinical medicine at unrelated points. In a few instances prophylactic inoculation is useful; antisera, of which we once hoped so much, are effective in still fewer; various serological reactions are used in diagnosis. Nevertheless we learn from the Rh reactions that wbat may now seem merely test-tube serology may at some time become the key to the aetiology and treatment of a serious disease. Until more is known of the physical chemistry of proteins and of the nature of inter-molecular forces many events in serology will remain disconnected. In teaching students this complicated subject, any detail of which may prove to be of vital importance, Prof. Boyd considers that the chief emphasis should be on serology, "if by that we mean the science which studies the fundamental mechanism of immunological reactions and their theoretical foundations." He recounts fully our present knowledge of antibodies, the relation of the specificity of antigens to structure, and the nature of antigen-antibody reactions. Some of the more advanced material is printed in small type to distinguish it from that "which the beginner can and should be expected to master," but even the remainder is more than any beginner could digest. Prof. Boyd, who does not oversimplify his subject, modestly hopes that the book will be of some use to the professional immunologist. He might have claimed much more: the book should be of the greatest value to any who are engaged in or intend to take up immunology as a special study. He presents the theoretical aspects of the subject fully and clearly, and has co-ordinated much material that previously lay scattered about the literature. The book is written in his usual agreeable style. J. R. MARRACK.


In the context of a study of the life-spans of primary teeth subjected to formocresol pulpotomy, 152 such teeth were compared with the corresponding teeth on the contralateral sides. The life-span of each tooth was determined by registration of the time of exfoliation or extraction. In addition, data were collected concerning factors which may influence the life-spans of teeth. The principal conclusions are: There was no significant difference in life-spans between primary teeth with or without pulpotomy. Premature loss due to extraction exerted virtually no influence on the mean life-span of primary teeth, regardless of whether a pulpotomy had been performed. There was no significant difference in the number of extractions of primary teeth with or without a formocresol pulpotomy. There was no significant difference in the mean life-span between primary teeth with vital and those with nonvital pulp at the time of formocresol pulpotomy.


Multipoint linkage analysis is commonly used to evaluate linkage of a disease to multiple markers in a small region. Multipoint analysis is particularly powerful when the IBD relations of family members at the trait locus are ambiguous. The increased power arises because, unlike single-marker analyses, multipoint analysis uses haplotype information from several markers to infer the IBD relations. We wish to temper this advantage with a cautionary note: multipoint analysis is sensitive to power loss due to misspecification of intermarker distances. Such misspecification is especially problematic when dealing with closely spaced markers. We present computer simulations comparing the power of single-point and multipoint analyses, both when IBD relations are ambiguous, and when the intermarker distances are misspecified. We conclude that when evaluating markers in a small region to confirm or refute previous findings, a situation in which p values of modest statistical significance are important, single marker analyses may provide more reliable measures of the strength of support for linkage than multipoint statistics.


OBJECTIVE: To develop guidelines for management and treatment of maladaptive aggression in youth in the areas of psychosocial interventions, medication treatments, and side-effect management. METHODS: Evidence was assembled and evaluated in a multistep process, including systematic reviews of published literature; an expert survey of recommended practices; a consensus conference of researchers, policymakers, clinicians, and family advocates; and review by the steering committee of successive drafts of the recommendations. The Center for Education and Research on Mental Health Therapeutics Treatment of Maladaptive Aggression in Youth guidelines reflect a synthesis of the available evidence, based on this multistep process. RESULTS: This article describes the content, rationale, and evidence for 11 recommendations. Key treatment principles include considering psychosocial interventions, such as evidence-based parent and child skills training as the first line of treatment; targeting the underlying disorder first following evidence-based guidelines; considering individual psychosocial and medical factors, including cardiovascular risk in the selection of agents if medication treatment (ideally with the best evidence base) is initiated; avoiding the use of multiple psychotropic medications simultaneously; and careful monitoring of treatment response, by using structured rating scales, as well as close medical monitoring for side effects, including metabolic changes. CONCLUSIONS: Treatment of children with maladaptive aggression is a "moving target" requiring ongoing assimilation of new evidence as it emerges. Based on the existing evidence, the Treatment of Maladaptive Aggression in Youth guidelines provide a framework for management of maladaptive aggression in youth, appropriate for use by primary care clinicians and mental health providers.


This study examines the socio-economic determinants of access to safe toilet facilities in Nigerian households. It also investigates the factors responsible for rural-urban disparity in accessing safe toilets among Nigerians. It uses the 2013 Demographic Health Survey (DHS) on Nigeria for all the analyses. Binary and Ordered Probit Regressions Models as well as Oaxaca-Blinder decomposition were used to determined factors affecting access to safe toilet facilities in the country. The results shows that, households head age, marital status, gender, household size, education, wealth index, locations, ethnicity and geopolitical variations are the significant determinants of households' access to safe toilets in Nigeria. While, household size, rural locality, zones, gender, and lower wealth index have negative impacts; households head age, marital status, ethnicity and education level, have positive effects on the households' access to safe toilets in the country. Secondly, differences in the age of households head, household size, wealth index, gender, zones and marital status are the factors responsible for the rural-urban variation in access to safe toilets in Nigeria. The study recommends poverty reduction programmes, public-private partnership, provision of public toilets, rural development, educational improvement, cultural and value re-orientation and social security programme among others as measures to improve access to safe toilet facilities in the country. Keywords: Safe toilets, socioeconomic, probit, Blinder-Oaxaca decomposition and socio-economic development.


Objective: To know the factors listed by puerperal woman that influenced the choice in type of delivery. Methods: Qualitative research, developed with 25 puerperal women in a University Hospital of Mato Grosso do Sul, between September and November 2014. A semi-structured interview was used for data collection and the Collective Subject Discourse was used to organize and tabulate the data collected. Results: The Collective Subject Discourses resulted in the following categories: Desire for the type of delivery; Respect for the chosen type of delivery and Factors that influenced the choice. Most of the women interviewed (76%) expressed a preference for normal birth due to rapid recovery, less pain and suffering. Conclusions: The influence of family members, previous experience with childbirth, professional-customer interaction and internet information influenced the type of delivery chosen, which reinforces the importance of health education since the pre-natal stage, highlighting the need to equip women to perform a conscious choice.


In recent years, increased loading and low weight requirements have led to the need for automatic crack tracing software. At MTU a purely hexahedral code has been developed in the nineties for Mode-I applications. It has been used extensively for all kinds of components and has proven to be very flexible and reliable. Nevertheless, in transition regions between complex components curved cracks have been observed, necessitating the development of mixed-mode software. Due to the curvature of the crack faces, purely hexahedral meshes are not feasible, and therefore a mixture of hexahedral elements at the crack tip, combined with tetrahedral in the remaining structure has been selected. The intention of the present paper is to compare both methods and to point out the strength and weaknesses of each regarding accuracy, complexity, flexibility and computing time. Furthermore, difficulties arising from the out-of-plane growth of the crack such as the determination of the crack propagation direction are discussed.


The purpose of this study is to conduct a comparative analysis of stop-loss and buyand-hold strategies by investigating if the stop-loss strategies outperform the buy-andhold strategies. The evaluation criteria of whether stop-loss strategies can deliver better results are defined as cumulative and mean returns. The study is conducted on daily returns data for stocks listed on the NSE 20 Share Index during the time period between January 2000 and December 2014 divided into holding periods of one year. We choose the beginning of each year as an arbitrary starting date for the holding periods. The performance of stop-loss strategies is tested by the trailing stop-loss where a stock is sold if the price reaches a certain percentage below the highest price since the starting date. The tested stop-loss strategies are 10%, 15%, 20%, 25% and 30% stop-loss strategies. We find only the 30% stop-loss strategy outperforming the buy-and-hold portfolio strategy. This means that a stock is sold if it declines by 30% from its highest price during the holding period in-order to limit on losses. During the bearish years all the stop-loss strategies outperformed the buy-and-hold strategy. However, during the bullish years, the buy-and-hold strategy outperformed the stoploss strategies. The stop-loss strategies perform in a more effective and consistent fashion when it comes to minimizing stock return variances The study therefore recommends the application of stop-loss strategies to a stock portfolio in order to minimize losses especially during market downturns.


This work focuses on two challenging types of problems related to quality assessment and comparison of thematic maps generated from remote sensing (RS) images when little or no ground truth knowledge is available. These problems occur when: (1) competing thematic maps, generated from the same input RS image, assumed to be available, must be compared, but no ground truth knowledge is found to assess the accuracy of the mapping problem at hand, and (2) the generalization capability of competing classifiers must be estimated and compared when the small/unrepresentative ground truth problem affects the RS inductive learning application at hand. Specifically focused on badly posed image classification tasks, this paper presents an original data-driven (i.e., unsupervised) thematic map quality assessment (DAMA) strategy complementary (not alternative) in nature to traditional supervised map accuracy assessment techniques, driven by the expensive and error-prone digitization of ground truth knowledge. To compensate for the lack of supervised regions of interest, DAMA generates so-called multiple reference cluster maps from several blocks of the input RS image that are clustered separately. Due to the unsupervised (i.e., subjective) nature (ill-posedness) of data clustering, DAMA provides no (absolute) map accuracy measure. Rather, DAMA's map quality indexes are to be considered unsupervised (i.e., subjective) relative estimates of labeling and segmentation consistency between every competing map at hand and the set of multiple reference cluster maps. In two badly posed RS image mapping experiments, DAMA's map quality measures are proven to be: (1) useful in the relative comparison of competing mapping systems; (2) consistent with theoretical expectations; and (3) in line with mapping quality criteria adopted by expert photointerpreters. Documented limitations of DAMA are that it is intrinsically heuristic due to the subjective nature of the clustering problem, and like any evaluation measure, it cannot be injective.


This thesis is an anthropological exploration of Irritable Bowel Syndrome (IBS), and the first ethnographic study of people with IBS in New Zealand. It explores the illness experience of people with IBS and whether stigma plays a role within this experience. IBS is a gastrointestinal illness that affects 10-20% of New Zealand's population. However, its aetiology is unknown, there is no cure, and the biomedical approach that informs its diagnosis and treatment is often incongruous with its lived experience. I posit that the illness experience of my participants and what is stigmatising for them must be understood not only in relation to its physical manifestations but also in relation to the biomedical and neoliberal influences that inform social expectations of the body and social participation. Further, participants experience their IBS simultaneously resisting and participating within these influences to make sense of and manage their illness in a way that aligns with their lived experiences.  All work within this thesis is my own except where otherwise stated.


Emergency medical personnel (firefighters and ambulance personnel) have higher levels of lifetime PTSD symptoms than the general population. Historically this has been attributed to the number of exposures to traumatic incidents, called the dose effect, but recent literature has suggested that there is a complex web of variables that affect an individual's experience of trauma. Through an interpretive review of the literature this dissertation takes the concepts supported by empirical research and organizes them into an integrated theoretical structure. With ecological psychology at the core, the integration uses Living Systems theory as a structure with which to organize and explore the different interactive ways that the environment in which emergency medical personnel live affects their experience of stress, coping skills, and overall resilience. At each level in the system, the effects on an individual's experienced or perceived resources are evaluated using Conservation of Resources theory. By using this theory, resources from variables as broad as global recessions to as precise as nutrition and brain functioning can be explored in a cohesive way that shows the interplay of resources across the system and the acute effects on individuals in the emergency medical field. This dissertation uses this model to identify junctures at each of the eight levels of living systems where resources can be addressed in a clinically relevant way. Limitations of current research data and implications for future research and clinical interventions are discussed.


Background: Schizophrenia is a widespread neurodegenerative disorder, which affects approximately 1% of the world population. It is a multifactorial and a highly heritable disease to which genetic factors contribute up to approximately 80%. Nowadays, multitude of genes have been discovered that relate to this disorder mostly by affecting the performance and levels of neurotransmitters in neural systems. Since PAI-1 is a considerable gene in the performance of neural systems, the present study dealt with the relationship between -675 4G/5G polymorphism in PAI-1 gene and schizophrenia among Iranian patients. Methods: This case-control study was carried out on 106 blood samples collected from individuals suffering from schizophrenia and 122 healthy controls. DNA was extracted from the samples and the frequency of the polymorphisms was analyzed using ARMS-PCR method. Finally, the products were detected on 2% agarose gel electrophoresis. Results: The analysis of the data for -675 4G/5G polymorphism showed that 17.9% of the patients and 1.6% of the controls were mutant homozygous and 65.1% of the patients and 45.9% of controls were heterozygous. Also, 17% of the patients and 52.5% of the controls were normal homozygous. Conclusion: There was a significant relationship between PAI-1 4G/5G polymorphism and the incidence of schizophrenia. To the best of our knowledge, this is first study in Iran that assesses the frequency of the polymorphism among Iranian patients. However, further studies with more samples are necessary.


A large number of potential light nonaqueous-phase liquid (LNAPL) traps exist in poorly sorted sands underlying the buried valley train surfaces in the lower Mississippi River Valley (LMRV). These traps should be considered during site characterization and remediation activities related to spilled nonaqueous-phase liquids and leaking underground storage tanks on the valley train surfaces of the LMRV. These traps have apparent average dimensions of 0.84 by 0.21 km (0.52 by 0.13 mi), with an average closure height of 2.7 m (8.85 ft). The maximum apparent lateral dimensions are 4.19 by 0.69 km (2.6 by 0.42 mi) and the minimum observed lateral dimensions are 0.06 by 0.02 km (0.03 by 0.01 mi). Apparent closure heights range from less than 1 m (3 ft) to an apparent maximum of 7.6 m (24.93 ft). A depth of about 4.3 m (14.1 ft) is assumed to be a maximum likely excavation depth for underground storage tank installations in the LMRV. The top stratum thickness in 47 of the 100 borings used to construct cross sections in this study was less than 4.3 m (14.1 ft). Thus, it is likely that underground storage tank installations, for example, have or will breach the top stratum at many sites on the valley train surfaces. In order for spilled LNAPLs from underground storage tank sites to migrate into one of these traps, it is probably necessary that the original excavation breach the low-permeability top stratum and that the water table seasonally fluctuates from below the base of the top stratum to above the base of the top stratum.


OBJECTIVE
Stress is known to be a significant risk factor for coronary atherosclerosis and adverse cardiovascular events; however, the stress-related coronary atherosclerotic burden has not yet been investigated. The aim of this study was to investigate the relationship between the Perceived Stress Scale (PSS) and the SYNTAX scores in patients with ST-segment elevation myocardial infarction (STEMI).

METHODS
A total of 440 patients with STEMI were prospectively enrolled and divided into 2 groups according to the PSS score with a ROC curve analysis cut-off value of 17.5. In all, 361 patients with a low PSS score were categorized as Group 1 and 79 patients with a high PSS score were categorized as Group 2.

RESULTS
The SYNTAX score [Group 1, 16.0 (10.0-22.5); Group 2, 22.5 (15.0-25.5); p<0.001] and the SYNTAX score II were significantly higher in Group 2 [Group 1, 24.8 (19.0-32.6); Group 2, 30.9 (22.3-38.9); p<0.001]. Spearman analysis demonstrated that the PSS score was associated with the SYNTAX score (r=0.153; p=0.001) and the SYNTAX score II (r=0.216; p<0.001). Additionally, the PSS (odds ratio: 2.434, confidence interval: 1.446-4.096; p=0.001) was determined to be an independent predictor of a moderate-to-high SYNTAX score. The PSS score of patients with in-hospital mortality was also higher than those who survived [15 (10-20); 9 (4-16), respectively; p=0.007].

CONCLUSION
Stress appears to accelerate the coronary atherosclerotic process and the associated burden. An increased stress level was found to be an independent predictor of a high SYNTAX score.


As an introduction to the current approaches to building's greening and sustainability this paper outlines the intrinsic harmony of the traditional village houses encompassing efficiency and balanced use of renewable materials and energy sources. Further paper reviews technical advances in integrating energy efficiency, solar and other renewable energy sources in new and existing buildings, to approach sustainable net Zero Energy Buildings, villages and cities. Paper stresses importance of the BPS (Building Performance Simulation) and Co-simulation in developing reliable method/engineering procedures for RES co-utilization and interwoven "energy mix" scenarios optimization, including existing buildings RES integrated refurbishment. Finally, presented are study results on the technical feasibility of efficient/cost-effective use of relatively low temperature geothermal waters for co- and tri-generation of electricity and heat for heating and/or cooling by absorption refrigeration for building integration. As a result of global warming a need for air-conditioning is in extreme growth in Central and Southeastern Europe, as well as in many other regions in the world rich in low temperature geothermal waters <100°C (<212°F), and there is a growing interest to utilize these waters in an efficient and cost effective way. It is well known that Kalina thermodynamic cycle can convert relatively low temperature energy, at relatively low temperature difference towards environment, to mechanical power and further to electricity using as a working fluid mixture comprised of at least two different components (water and ammonia). However, its co-generation efficiency at the heat source temperatures below and about 100°C is too low. That was the reason to explore technical possibilities to expand the low-temperature Kalina cycle's geo-water utilization for co- and tri-generation based on the co-utilization - hybridization of geothermal with solar or other renewable energy sources (RES).


The digital world is continuously changing, and new technologies affecting every aspect of our life. In order to keep up with these changes and have some impact and/or control over it; we must conduct advanced research on information technologies, future networks and security. In addition, we must educate the necessary human resource for the field. Today, developed countries are establishing large-scale research and education testbeds to support their researchers. Using these testbeds, they seek to increase their impact in the technology and security fields. In this paper, we propose a national information and communication technologies and security testbed, TRCyberLab. We also propose a road-map for the establishment and sustainment of this testbed. We believe, this testbed will help researchers in Turkey to conduct advanced research and develop new technologies also have an impact in the field.


BackgroundThe study of the PCa immune microenvironment has brought new opportunities for the clinical diagnosis and treatment of PCa, but the current study has failed to obtain satisfactory results. We aim to develop a generalized, individualized immune prognostic signature that can improve the survival rate of patients.MethodsWe collected a total of 591 sample data from the TCGA and GEO cohorts, and evaluated the abundance and distribution of immune cell members in the mixed cell population in the gene expression matrix by CIBERSORT, ESTIMATE, ssGSEA, and other methods. Calculate the TMB value of the mutant gene to evaluate the reliability of PCa for immunotherapy. Besides, the genes related to the immune microenvironment and mutation load of PCa are obtained, and the target genes are obtained by the intersection with the immune-related genes in the ImmPort database. And perform pan-cancer analysis of the target gene to evaluate the immunological commonality and biological pathways in a variety of cancers. Finally, a Western blot experiment was used to explore the mechanism of the target gene in PCa immune microenvironment.ResultsWe found that M0, M2, and Mast cell sresting differed significantly between prostate cancer and normal tissue and that patients with low plasma cell abundance were more likely to develop lymph node metastasis. LTF, as a core gene, is closely related to changes in the immune microenvironment of PCa, and its low expression in tumors promotes primary immune deficiency, cancer development, and enrichment in the JAK/STAT signaling pathway. Cell experiments found that LTF overexpression reduces tumor-derived GM-CSF secretion by inhibiting JAK/STAT pathway, achieving the purpose of regulating tumor immune microenvironment and inhibiting PCa cell proliferation and migration.ConclusionsThe proposed clinical-immune signature and core gene is the most promising biomarkers for improving the overall survival rate of PCa. It has been verified that overexpression of LTF reduces the secretion of tumor-derived GM-CSF by inhibiting the JAK/STAT pathway.


Introduction. An important factor determining survival after out-of-hospital cardiac arrest is how fast the ambulance personnel can reach the patient. Materials and methods. In a two-year period between 1996 and 1998, all ambulance calls to patients with out-of-hospital cardiac arrest in Oslo were evaluated. Of 1 026 cardiac arrests, 130 were excluded because of missing data. Results. The median ambulance response interval was 7.2 min (5.7–9.0 as 25–75 % percentiles). There was a tendency to shorter response intervals to the central parts of Oslo with medians between 3 and 4 min, while 14 more peripheral boroughs had median response intervals over 8 min. Of the 627 cases where the ambulance starting point was registered, 76 % were from the only ambulance station in Oslo, located downtown. Interpretation. In our opinion, the median ambulance response interval is unsatisfactory in large parts of Oslo, as a long response time gives a dramatically lower survival rate after cardiac arrest. A reorganisation and decentralisation of the Oslo Emergency Medical Service System seems necessary.


Motivated by mass-spectrometry protein sequencing, we consider the problem of reconstructing a string from the multisets of its substring composition. We show that all strings of length 7, one less than a prime and one less than twice a prime, can be reconstructed uniquely up to reversal. For all other lengths, we show that unique reconstruction is not always possible and provide sometimes-tight bounds on the largest number of strings with given substring compositions. The lower bounds are derived by combinatorial arguments, while the upper bounds follow from algebraic approaches that lead to precise characterizations of the sets of strings with the same substring compositions in terms of the factorization properties of bivariate polynomials. Using results on the transience of multidimensional random walks, we also provide a reconstruction algorithm that recovers random strings over alphabets of size ≥ 4 from their substring compositions in optimal near-quadratic time. The problem considered is related to the well-known turnpike problem, and its solution may hence shed light on this longstanding open problem as well.


The safety and resilience of fully autonomous vehicles (AVs) are of significant concern, as exemplified by several headline-making accidents. While AV development today involves verification, validation, and testing, end-to-end assessment of AV systems under accidental faults in realistic driving scenarios has been largely unexplored. This paper presents DriveFI, a machine learning-based fault injection engine, which can mine situations and faults that maximally impact AV safety, as demonstrated on two industry-grade AV technology stacks (from NVIDIA and Baidu). For example, DriveFI found 561 safety-critical faults in less than 4 hours. In comparison, random injection experiments executed over several weeks could not find any safety-critical faults.


We study distributed inference, learning and optimization in scenarios which involve networked entities intime-varying and random networks, which are ad-hoc in nature. In this thesis, we propose distributed recursivealgorithms where the networked entities simultaneously incorporate locally sensed information andinformation obtained from the neighborhood. The class of distributed algorithms proposed in this thesisencompasses distributed estimation, distributed composite hypothesis testing and distributed optimization.The central theme of the scenarios considered involve systems constrained by limited on board batteriesand hence constrained by limited sensing, computation and extremely limited communication resources.A typical example of such resource constrained scenarios being distributed data-parallel machine learningsystems, in which the individual entities are commodity devices such as cellphones.Due to the inherent ad-hoc nature of the aforementioned setups, in conjunction with random environmentsrender these setups central coordinator-less. Keeping in mind the resource constrained nature of such setups,we propose distributed inference and optimization algorithms which characterize the interplay betweencommunication, computation and optimality, while allowing for heterogeneity among clients in terms of objectives,data collection and statistical dependencies.With massive data, models for learning and optimization have been getting more and more complex to theextent of being almost analytically intractable. In such models, obtaining gradients for the associated lossfunction is very expensive and potentially intractable due to the lack of a closed form for the loss function.A major thrust of this thesis is gradient free zeroth order optimization which encompasses distributed setupswhich exhibit data parallelism and also potentially analytically intractable loss functions. On top ofgradient free optimization, in this thesis we also study projection free zeroth order methods for constrainedoptimization.The techniques developed in this thesis are generic and are of independent interest in classical fields such asstochastic approximation, statistical decision theory and optimization.


Fundamental issues of natural resource management revolve around diverse worldviews, knowledges and practices, which cannot all be captured within the policy framework. The Western worldview, which reflects mainly the utilitarian, economistic view of resources, has influenced and shaped the trend management of natural resources has taken world-wide. The Western worldview contrasts with local knowledges, which are uniquely innovative, highly dynamic, tacit, contextual and/or locality-specific. This thesis explores the fuelwood problem in Nyando Division of Kisumu District in Kenya, seeking both a holistic understanding and an emphasis on the interface between official policy and local rural practice, including the varying knowledges. The study focused on two case study clans, Muga and Kadhier in Awasi and Kochogo Locations, respectively. Most fuelwood in the study areas is from on-farm and multiple accessible sources. This contradicts the 'fuelwood orthodoxy' school which associates fuelwood consumption with deforestation and 'woodfuel crisis'. Aerospace imageries clearly illustrated a change and decline in stand density of the woody vegetation cover in Nyando Division over time. Differences in fuelwood availability and inequalities in endowment of wood/tree resources in and between the study localities exemplify critical questions of entitlement in the face of 'abundance'. Tree planting was not seen to be synonymous with fuelwood availability. This scenario promotes the fuelwood trade, high dependence on fuelwood purchase and supplements of crop residues by local households. Land privatisation has exacerbated the situation. Distances travelled to collect fuelwood have decreased as people turn to alternative and purchased fuels. Opportunities in the study area for the resolution of the fuelwood problem include promotion of less culturally restricted and less economically valuable trees, and a more farmer-sensitive approach from government and NGOs which recognises farmers as active partners in the interface between policy and rural practice.


Spongy bone produces local magnetic field inhomogeneities and leads to shortening of the transverse relaxation time from bone marrow. This increased signal decay affects the T2 relaxation time. Measurements of the T2* time from the 4th lumbar vertebra were carried out in 48 normals and 20 patients with osteoporosis. A special multigradient echo technique was used, the echo times selected in relation to phase coherence of the water and fat signals. T2* times showed slight increase in relation to age. Patients with osteoporosis showed significantly increased T2* times (19.9 +/- 3.8 ms) compared to the normal control group (13.4 +/- 1.9 ms). From these findings it is possible to judge the quality of the trabecular structure.


Antimicrobial resistance (AMR) is a leading global health issue, though the impact on companion animal health remains poorly understood. To address this we used a health informatics approach, focusing on four key objectives: (i) Antimicrobial prescription monitoring: Using data from the Small Animal Veterinary Surveillance Network (SAVSNET), pharmaceutical prescriptions from 1,000,000 canine and 350,000 feline electronic health records (EHRs) collected from 250 voluntary veterinary practices in the UK were summarised. After vaccines and anti-inflammatories, antimicrobials were the third most commonly prescribed pharmaceutical family, though a significant reduction in prescription frequency was observed between 2014 and 2016. Clavulanic acid potentiated amoxicillin and cefovecin were the most commonly prescribed antimicrobials to dogs and cats respectively. Practices that frequently prescribed antimicrobials to dogs also frequently prescribed to cats. In both species, respiratory conditions were commonly associated with systemic antimicrobial prescription. (ii) Antimicrobial resistance monitoring: Antimicrobial susceptibility test (AST) results were summarised from 29,000 canine and 8,000 feline Enterobacteriaceae isolates collected from four veterinary diagnostic laboratories (VDLs). Between 2016 and 2018, phenotypic multi-drug resistance (MDR) was detected in 6.5% of canine and 2.6% of feline E. coli isolates. Temporal prevalence remained fairly static, though geographical; VDL and practice-level variation was noted. Genotypic analyses of 148 MDR Enterobacteriaceae clinical isolates revealed extended spectrum β-lactamase genes to be common (63.5% of isolates). Of these, blaCTX-M-15 was commonly identified, as was the E. coli sequence type 131:O25b pandemic clone (n=6 isolates). blaACC was also detected for the first time in companion animals (n=2). (iii) Exploring factors associated with antimicrobial prescription and resistance: Examining consultations where the animal presented as unwell, a range of prior preventive health care decisions (including vaccination, insurance or neutering) were associated with significantly decreased odds of systemic antimicrobial prescription, as were Royal College of Veterinary Surgeons (RCVS) accredited veterinary practices. Considering AST results, practices examining referral cases alone or practices that employed RCVS-certified specialists were associated with significantly increased odds of phenotypic E. coli MDR in dogs. (iv) Gathering clinical evidence: A cohort of 3,000 dogs primarily presenting with acute diarrhoea were followed longitudinally through their EHR. Nearly 50% of cases were prescribed a systemic antimicrobial; increased case severity was associated with heightened odds of prescription. Most cases were considered resolved by 10 days post-initial presentation. No association between antimicrobial prescription and resolution was found, though nearly a quarter of cases were lost to follow-up. By taking a health informatics approach, these studies have identified unique and important opportunities for future strategic clinical antimicrobial stewardship interventions. Together these studies create a vision for how a health informatics approach can effectively monitor and characterise antimicrobial prescription and resistance in companion animals across the UK, a group of animals that has previously largely been neglected in population level statistics. To further build on this work, we recommend five areas for future development including: (1) further one health-focused collaboration and cohesion; (2) continued development of effective surveillance methodologies; (3) expanding scope of informatics-focused surveillance projects; (4) ensuring that academic findings inform surveillance and policy at governmental and inter-governmental levels, and (5) developing interventions that can encourage antimicrobial stewardship within veterinary practice.


Verbal irony is a common phenomenon in communication, but its convoluted nature makes it difficult to translate. This book expands on previous studies of the translation of irony by examining the mechanisms of verbal irony in its translation from Catalan and Spanish into English. It accentuates the importance of ironic cues not only in processing irony but also in rendering it across cultures. It also interrogates its translatability in the narratives of two Latin American authors, Julio Cortázar and Juan José Arreola, and two Catalan writers, Pere Calders and Quim Monzó. Comparative analyses of the source and target texts further reveal obstacles in the cross-cultural communication of irony. Based on a proposed classification of ironic cues, this book provides guidelines for the effective translation of irony. The corpus, which is subject to an interdisciplinary analysis rooted in Discourse Stylistics, comprises a compelling range of short stories that tacitly bespeak the authors' stances towards twentieth-century sociohistorical events as well as more general contemporary issues. The connection between Calders's and Cortazar's exiles and their ironic styles is equally explored.


A three‐dimensional prestack depth‐migrated seismic reflection data volume acquired off Shikoku Island, Japan covers the seaward portion of the Nankai Trough accretionary prism. We calculate and interpret total horizontal shortening lengths along three cross‐sectional profiles through the volume, incorporating a technique addressing the significant amount of water volume sediments lose during accretion, constrained by porosity values derived from seismic interval velocities. The results reveal a total horizontal shortening of ∼40% within sediments of the first three thrust sheets in the wedge. This indicates that structural restorations applied to water‐saturated young sediments, or other domains displaying large tectonic‐induced porosity changes (e.g., accretionary prisms, subaerial and submarine fold and thrust belts), must account for the substantial amount of distributed compactive strain that affects the sediment during the initial stages of accretion. Our analysis of the porosity reduction also allows an estimate of dewatering rates across the outer accretionary wedge. We find that porosity loss and associated dewatering decrease with distance landward from the trench and correspond to a progressively decreasing contribution of diffuse compactive strain to the total shortening. We compute a dewatering rate of 10.5 km3/Ma (per km along strike) over the outer ∼7 km of the accretionary wedge. This relatively high rate of dewatering when compared to other well‐studied subduction systems probably reflects the large thickness of accreted sediment and high sediment permeability that allows efficient consolidation. These results highlight the importance of considering distributed compactive strain in structural restorations for any setting where deformation occurs in sediments.


Previous studies have demonstrated that both retinoids and apelin possess potent cardiovascular properties and that retinoids can mediate the expression of many genes in the cardiovascular system. However, it is not clear whether and how retinoids regulate apelin expression in rat VSMCs (vascular smooth muscle cells). In the present study, we investigated the molecular mechanism of apelin expression regulation by the synthetic retinoid Am80 in VSMCs. The results showed that Am80 markedly up-regulated apelin mRNA and protein levels in VSMCs. Furthermore, KLF5 (Krüppel-like factor 5) and Sp1 (stimulating protein-1) co-operatively mediated Am80-induced apelin expression through their direct binding to the TCE (transforming growth factor-β control element) on the apelin promoter. Interestingly, upon Am80 stimulation, the RARα (retinoic acid receptor α) was recruited to the apelin promoter by interacting with KLF5 and Sp1 prebound to the TCE site of the apelin promoter to form a transcriptional activation complex, subsequently leading to the up-regulation of apelin expression in VSMCs. An in vivo study indicated that Am80 increased apelin expression in balloon-injured arteries of rats, consistent with the results from the cultured VSMCs. Thus the results of the present study describe a novel mechanism of apelin regulation by Am80 and further expand the network of RARα in the retinoid pathway.


UNLABELLED: Although Doppler echocardiography methods (DM) of lung veins transmitral and blood flows analysis traditionally used in a left ventricular (LV) diastolic dysfunctions (DD) non-invasive diagnostics are positive they also have their considerable shortcomings. A Tissue Doppler echocardiography method (TDM) has its advantage as it is independent of haemodynamic heart function in an analysis of CHF patients. AIM: To study capabilities of the both methods (DM and TDM) in an analysis of CHF patients diastolic left ventricular dysfunctions. To determinate sensitivity, specificity and reproductivity of TDM. MATERIALS AND METHODS: 80 CHF I-IV NYHA classes patients and 20 healthy volunteers (a control group) are studied. The patients were divided into 3 groups depending on their transmitral flow specters: first with LV relaxation dysfunction (n=24), second with pseudonormal type (n=33), third with restrictive type (n=23). In the general group a LV DD comparative analysis on DM and TDM results is done. In the second group these methods were compared as giving diagnostically DD data. For far finer TDM results in the group of 30 patients the data were compared with radionuclear vetriculography. RESULTS: The usage of two TDM diagnostic criteria gives more CHF patients than DD method (81.1% to 75.8%). TDM sensitivity in left ventricular DD is up to 70%, specificity--over 90%, reproductivity--73-87%.


Lipopolysaccharide (LPS) is an essential component of the outer membranes (OM) of most Gram-negative bacteria, which plays a crucial role in protection of the bacteria from toxic compounds and harsh conditions. The LPS is biosynthesized at the cytoplasmic side of inner membrane (IM), and then transported across the aqueous periplasmic compartment and assembled correctly at the outer membrane. This process is accomplished by seven LPS transport proteins (LptA-G), but the transport mechanism remains poorly understood. Here, we present findings by pull down assays in which the periplasmic component LptA interacts with both the IM complex LptBFGC and the OM complex LptDE in vitro, but not with complex LptBFG. Using purified Lpt proteins, we have successfully reconstituted the seven transport proteins as a complex in vitro. In addition, the LptC may play an essential role in regulating the conformation of LptBFG to secure the lipopolysaccharide from the inner membrane. Our results contribute to the understanding of lipopolysaccharide transport mechanism and will provide a platform to study the detailed mechanism of the LPS transport in vitro.


Recent successful CFD models of cryocooler systems have shown that such models can provide very useful performance predictions for cryocoolers. For miniature cryocoolers, CFD modeling is likely the best technique available as models developed for larger systems may not accurately represent phenomena which become important as the device scale is reduced. Accurate CFD modeling of Stirling and pulse tube refrigerators requires realistic closure relations, particularly with respect to the hydrodynamic and thermal transport processes for the porous media which make up their heat exchangers and regenerators. Generally, these porous media are morphologically anisotropic, and thus the parameters which characterize them are anisotropic as well. Measurement of the hydrodynamic parameters in at least two dimensions is therefore preferred. Miniature regenerative cryocoolers will require porous regenerator and heat exchanger fillers with considerably smaller characteristic pore sizes than those commonly used in larger scale devices. This paper describes measurements of the hydrodynamic parameters of stacked discs of 635 mesh stainless steel and 325 mesh phosphor bronze using a CFD-assisted methodology. These materials are among the finest commercially available structures and can be suitable for use as miniature regenerator and heat exchanger fillers. Measurements were made in the axial and radial directions for both steady and oscillatory flow. Higher frequency operation is preferred for miniature cryocoolers; therefore a frequency range between 50 and 200 Hz was investigated for the oscillatory flow cases. The test setups for steady flow incorporated static pressure transducers and a mass flow rate meter; for oscillatory flow, the apparatus included dynamic pressure transducers and hot wire probes for CFD model verification. These test setups were each modeled using the Fluent CFD code. The directional Darcy permeability and Forchheimer's inertial coefficients were obtained based on iterative comparisons between experimental measurements and CFD simulation results.


ABSTRACT Fatty acid synthase in the yeast Cryptococcus neoformans is composed of two subunits encoded by FAS1 and FAS2 genes. We inserted a copper-regulated promoter (PCTR4-2) to regulate FAS1 and FAS2 expression in Cryptococcus neoformans (strains PCTR4-2/FAS1 and PCTR4-2/FAS2, respectively). Both mutants showed growth rates similar to those of the wild type in a low-copper medium in which FAS1 and FAS2 were expressed, but even in the presence of exogenous fatty acids, strains were suppressed in growth under high-copper conditions. The treatment of C. neoformans with fluconazole was shown to have an increased inhibitory activity and even became fungicidal when either FAS1 or FAS2 expression was suppressed. Furthermore, a subinhibitory dose of fluconazole showed anticryptococcal activity in vitro in the presence of cerulenin, a fatty acid synthase inhibitor. In a murine model of pulmonary cryptococcosis, a tissue census of yeast cells in PCTR4-2/FAS2 strain at day 7 of infection was significantly lower than that in mice treated with tetrathiomolybdate, a copper chelator (P < 0.05), and a yeast census of PCTR4-2/FAS1 strain at day 14 of infection in the brain was lower in the presence of more copper. In fact, no positive cultures from the brain were detected in mice (with or without tetrathiomolybdate treatment) infected with the PCTR4-2/FAS2 strain, which implies that this mutant did not reach the brain in mice. We conclude that both FAS1 and FAS2 in C. neoformans are essential for in vitro and in vivo growth in conditions with and without exogenous fatty acids and that FAS1 and FAS2 can potentially be fungicidal targets for C. neoformans with a potential for synergistic behavior with azoles.


One may have different objectives in interpreting texts. This paper argues that these different aims, applicative and historical ones, require different methodologies. Furthermore, we should apply the methodology of historical interpretation to the entire body of German texts now available, if we want to interpret Heidegger's philosophical oeuvre, assess its value, and investigate its links to Nazism.


). In the developments of NLO polymers for electro-opti c device applications, stabiliza-tion of electrically induced dipole alignment is one of impor-tant criteria; in this context, two approaches have been pro-posed to minimize the randomization of dipole alignment namely the use cross-linking method


To combat the COVID-19 pandemic, vaccines against SARS-CoV-2 are now given to protect populations worldwide. The level of neutralizing antibodies following the vaccination will evolve with time and vary between individuals. Immunoassays quantifying immunoglobulins against the viral spike (S) protein in serum/plasma have been developed, but the need for venous blood samples could limit the frequency and scale of control in populations. The use of a quantitative dried blood spot (DBS) that can be self-collected would simplify this monitoring. The objective of this study was to determine whether a quantitative DBS device (Capitainer qDBS 10 µL) could be used in combination with an Elecsys anti-SARS-CoV-2 S immunoassay from Roche to follow the development and persistence of anti-S antibodies. This objective was carried out through two clinical studies. The first study investigated 14 volunteers who received two doses of the Comirnaty (Pfizer) vaccine. The levels of anti-S antibodies and the progression over time post-vaccination were studied for three months. The level of produced antibodies varied between subjects, but a similar trend was observed. The anti-S antibodies were highly stimulated by the second dose (×100) and peaked two weeks later. The antibody levels subsequently decreased and three months later were down to 65%. DBS proved to be sufficiently sensitive for use in evaluating the immune status against SARS-CoV-2 over a prolonged time. The second cohort was composed of 200 random patients from a clinical chemistry department in Stockholm. In this cohort, we had no information on previous COVID-19 infections or vaccination. Nevertheless, 87% of the subjects had anti-S immunoglobulins over 0.8 U/mL, and the bias between plasma and DBS proved to be variable, as was also seen in the first vaccination study.


Eosinophilic granuloma (EG), Letterer-Siwe disease and Hand-Schuller-Christian disease are collectively called Langherans-cell histiocytosis (LCH). While the latter two are systemic diseases, the former is a localized form of histiocytosis. Solitary EG of the skull are rare lesions characterized by a natural history not well defined yet. In this context, we report a case of a 23-year-old male suffering for a recurrent and progressive right parietal headache. On computed tomography (CT) it was observed an ostelytic lesion which on magnetic resonance imaging (MRI) appeared as an hyperintense soft mass on both T1 and T2 weighted images. The lesion showed a marked and heterogeneous enhancement after gadolinium administration. The surgical excision was complete and the severe headache disappeared. Immunohistochemical analysis of the specimen indicated an eosinophilic granuloma characterized by Ki-67 nuclear antigen expression with a labeling index of 20%. In the pertinent literature we have found two aggressive cases of EG showing the Ki-67 expression with a respectively 6.2% (occipital bone granuloma) and 10% (parietal bone granuloma) labeling index. That high proliferative activity suggests a local Langherans' cell proliferation along with an exuberant inflammatory response and also explains the aggressive clinical course and the rapid expansion of the lesion observed in some rare cases of solitary EG. This is the third case-report of calvarial EG characterized by Ki-67 nuclear antigen expression.


Compliance with the European Union Urban Waste Water Treatment Directive ('the Directive') is a pre-requisite for achieving the primary objective of the Water Framework Directive. 11 EU-27 Member States had to comply with certain requirements of the Directive by 2005. Figures released in 2009 revealed a lack of compliance for wastewater treatment, but 100% compliance for wastewater collection in 8 out of the 11 Member States. This high level of compliance has been facilitated by significant investment in collection and combined sewer overflow (CSO) discharge prevention approaches and technologies. For cities with population equivalent in excess of 1 million, the most common approach to resolving CSO issues was identified to be the addition of extra capacity. Within some cities the use of these approaches was complemented by the use of real-time control (RTC) and several cities combined both of these approaches with waste water treatment plant (WWTP) expansion and/or sewer separation. Two cities were identified as utilising source control techniques, alongside conventional approaches. Four projects utilised tunnels, in combination with WWTP expansion and RTC. It is apparent that there is not a 'one size fits all' intervention in dealing with problematic CSOs, when trying to comply with the Directive.


Cutaneous mucinosis is a rare disease that manifests as an excessive accumulation of mucin in the skin that forms waxy papules or plaques. We report a case of a 44-year-old male psoriatic patient who developed generalized cutaneous mucinosis after 11 months of biological treatment. The patient had a history of psoriasis for 20 years and had been treated with narrow-band UVB phototherapy, methotrexate, or acitretin intermittently. He was started on etanercept after he was diagnosed with psoriatic arthritis, and 11 months later, he complained of swelling in his extremities and myxoid cysts on his fingers. Etanercept was then discontinued due to loss of efficacy and widespread skin lesions. However, the lesions subsided spontaneously after 6 months without specific systemic treatment.


This article investigates an under-researched area in the tourism and leisure literatures, recreational freshwater fishing, which has become a significant cultural activity and a tourism industry in its own right. Within the last 30 years many destinations across the globe have developed fishing packages/products designed for the enthusiast able to afford the trip. Similarly, a new generation of tour operators has emerged in the West to offer a world of choice that was hardly imaginable a few decades ago. The article maps important developments in the modern history of fishing from a social constructionist viewpoint, examining how fishing, and by extension fishing tourism, enlists and promotes certain performative codes of practice and being, and how certain gazes on nature, destinations, fishing technologies, skills and quarry are produced and reproduced in very particular ideological ways. The article also considers the embodied nature and the materiality of fishing and fishing tourism and advances conceptual directions on how fishing leisure and tourism combine to produce an identifiable actor-network that is made up of sub-networks. Here, the analysis focuses on how the community of fish, anglers, technology, destinations and travel are held together to create a material–semiotic set of spatial practices and performances that are contested, impassioned and networked in relational space–time. The overall aim of the article is to offer a contextual and theoretical account of this important area of tourism and leisure and point to fruitful avenues for future research.


AbstractAnthropologists such as Mary Helms have noted a historical linkage between the phenomena of perceived distance and perceived power. In this article I apply this paradigm to the history of European imperial expansion between the twelfth and the sixteenth century. In the Middle Ages, European popes and kings imbued the mythic ruler Prester John with great power in part because he was unseen and believed to live at a great distance. By associating the Mongols, and the Ethiopians after them, with Prester John, both of these peoples became an embodiment of this distance/power paradigm in Western European eyes. Latins hoped that the Mongols or Ethiopians would use their "power" to assist the West in their crusading battles in the Holy Land. When the Portuguese and Spanish began their voyages of expansion, they applied the same paradigm to the peoples they encountered in Asia, Africa and the Americas. When distance between Europe and these other continents was breached, however, the Iberian view of the others' power diminished. Simultaneously, the Spanish and Portuguese perception of their own power increased as they, not "Prester John", became the conquerors of distance.


In this project, a pattern reconfigurable simple two patch array antenna has been designed and implemented to operate at a fixed frequency of 2.4 GHz for beam scanning purpose. Proposed antenna operates at three different modes in which the radiation pattern steers 0°, ±30° with respect to the antenna broadside. In this article, a different approach has been taken to implement the reconfigurable antenna which is very simple and cost effective compared to previous works. For this, a SP3 RF switch is used to steer the radiation pattern by applying phase difference between the two antenna elements. A reconfigurable patch array is designed on a Rogers 5880 RT/DUROID substrate in which antenna element is fed in inset configuration. Measured and simulated results are well matched but with some minor deviations. Designed antenna array has a gain of 9 dBi in broadside and the gain drops to 7.5 dB when the beam is rotated by either ±30°. Pattern reconfigurable antenna can be used in wireless communication systems, where antenna pattern needs to be aligned with strongest signal sources or when the antenna needs to be kept away from noisy environments or interfering signals. © 2014 Wiley Periodicals, Inc. Microwave Opt Technol Lett 56:2377–2381, 2014


The annular solar eclipse observed on 21 June 2020 over Taiwan provided a rare opportunity to follow the responses of various meteorological parameters and trace gases to the solar eclipse. For the first time, the impact of the solar eclipse on solar radiation, air temperature (T), relative humidity (RH), atmospheric pressure (P), wind speed (WS), and trace gases (ozone and carbon monoxide) is delineated at the Lulin Atmospheric Background Station (LABS; 23.47 ° N, 120.87 ° E; 2,862 m MSL) in Taiwan. Over the T aiwan region, the solar eclipse began at 14:49 local time (LT; UTC+8), reached maximum obscuration at 16:13 LT, and finished at 17:24 LT. Compared to the control period (average of 13–20 June 2020), the weather parameters and trace gases show pronounced changes on the day of the eclipse (21 June 2020). A significant decrease in UV-B and solar irradiance at LABS was observed during the peak phase of the solar eclipse due to the occultation of the Sun by the Moon. On the eclipse day, the T decreased significantly ( ~ 4 ° C) after 17 minutes of maximum solar darkening. Due to the cloudiness and low temperatures on the day of the eclipse, 100% RH was apparent during the period of the eclipse at LABS. We also noticed a steady decline in WS just after the onset of the eclipse at LABS. Interestingly, a marked decline in ozone and carbon monoxide was seen during the eclipse day at LABS. Ozone was reduced by about 10 ppb (40%), with a delay of about 2 hours from the peak phase of the eclipse. Overall, our results show the impact of the solar eclipse on high altitude measurements for the first time, and further this work provides a useful new contribution to the literature examining solar eclipse-induced atmospheric changes.


The use of microfibre cloths for environmental cleaning has become ubiquitous in healthcare environments. However, there are issues with the re-use of microfibre cloths associated with their sterilisation and continued cleaning performance. Ozone-based laundry systems potentially provide an efficient route for the recycling of microfibre cloths; however it is necessary to demonstrate that this technology does not degrade their cleaning efficiency. The impact of an ozone-based laundry system on the cleaning efficiency of microfibre cloths was evaluated using a simulated wiping protocol. Two different types of microfibre cloth were investigated with no significant difference (p>0.05) in the cleaning efficiency of either type being found over one, 150 and 350 wash cycles. The cleaning performance of ozone treated cloths was also not significantly different from that of conventionally laundered (250 cycles) cloths.


For pt.1 see ibid., vol.45, no.1, p.73-84 (1997). This paper presents the results of and conclusions drawn from two experimental studies of low-elevation, slant-path scintillation. Part I related to 11.2-GHz measurements at an elevation angle of 3.3/spl deg/. Part II describes 14- and 11-GHz observations made on a (nominal) 10/spl deg/ path over a four year period. The resulting time-series data have enabled frequency scaling to be investigated in some depth. Scintillation occurring during periods unassociated with fading is found to be well modeled in its frequency scaling behavior by classical theories of clear air turbulence (CAT). This is not the case, however, for scintillation that occurs during, just before, or just after rain-induced fading. A rapidly fluctuating attenuation mechanism, not separable from CAT-induced scintillation on the basis of its spectrum alone, is thought to be responsible for this anomalous frequency-scaling result.


In the analysis of VERITAS and other IACT data, it is expected to get a distribution of statistical significances in sky map bins with mean of zero and width of unity in the absence of a $\gamma$-ray signal. However, it is not uncommon to see significance distributions of width greater than unity, indicating that the background is poorly estimated and the significances in the region of interest are incorrect. This work explores the origins of these wider significance distributions and develop solutions to this issue and test these solutions on samples of VERITAS data.


Accelerated Life Testing (ALT) is used to provide timely estimates of a product's lifetime distribution. Step-Stress ALT (SSALT) is one of the most widely adopted stress loadings and the optimum design of a SSALT plan has been extensively studied. However, few research efforts have been devoted to establishing the theoretical rationale for using SSALT in lieu of other types of stress loadings. This article proves the existence of statistically equivalent SSALT plans that can provide equally precise estimates to those derived from any continuous stress loading for the log-location-scale lifetime distributions with Type-I censoring. That is, for any optimization criterion based on the Fisher information matrix, SSALT is identical in comparison to other continuous stress loadings. The Weibull and lognormal distributions are introduced as special cases. For these two distributions, the relationship among statistical equivalencies is investigated and it is shown that two equivalent ALT plans must be equivalent in terms of the strongest version of equivalency for many objective functions. A numerical example for a ramp-stress ALT, using data from an existing study on miniature lamps, is used to illustrate equivalent SSALT plans. Results show that SSALT is not only equivalent to the existing ramp-stress test plans but also more cost-effective in terms of the total test cost.


Francis turbines are subject to various types of the cavitation flow depending on the operating conditions. In order to compensate for the stochastic nature of renewable energy sources, it is more and more required to extend the operating range of the generating units, from deep part load to full load conditions. In the deep part load condition, the formation of cavitation vortices in the turbine blade to blade channels called inter-blade cavitation vortex is often observed. The understanding of the dynamic characteristics of these inter-blade vortices and their formation mechanisms is of key importance in an effort of developing reliable flow simulation tools. This paper reports the numerical and experimental investigations carried out in order to establish the vortex characteristics, especially the inception and the development of the vortex structure. The unsteady RANS simulation for the multiphase flow is performed with the SST- SAS turbulence model by using the commercial flow solver ANSYS CFX. The simulation results in terms of the vortex structure and the cavitation volume are evaluated by comparing them to the flow visualizations of the blade channel acquired through a specially instrumented guide vane as well as from the downstream of the runner across the draft tube cone. The inter-blade cavitation vortex is successfully captured by the simulation and both numerical and experimental results evidence that the inter-blade vortices are attached to the runner hub.


The e!ects of supersaturation level, sodium chloride (NaCl) as impurity, and the suspension density of the crystallizer content on the crystallization kinetics of ammonium perchlorate (AP) were studied in a mixed-suspension mixed-product removal crystallizer. The product crystals have a plate-like morphology. The crystal size distribution is not a!ected by the supersaturation level. There was a deviation from the ideal population density where the growth rate of pure AP crystallization was size dependent with the order of 0.4 according to Abegg, Stevens and Larson (ASL) model. However, the ASL model was not found to be suitable to express the growth rate of the crystals in NaCl containing AP solution. Also when suspension density of the crystallizer increased, secondary nucleation was observed. ( 2000 Elsevier Science B.V. All rights reserved.


The most common symptoms of Mullerian cyst are abdominal discomfort and palpable abdominal mass. The diagnosis is based on the histological findings. Retroperitoneal Mullerian cysts should be completely excised. We report a case of a 41 years old woman treated for 2 retroperitoneal Mullerian cysts completely resected surgically. Retroperitoneal mullerian cyst is rare, the diagnosis is difficult preoperatively due to the lack of pathognomonic clinical and radiologic features. Its surgical excision is necessary to avoid recurrences. Mullerian cyst of the retroperitoneum is an extremely rare disease.  Only 15 cases have been reported in the literature. They are characterized by the development of Mullerian epithelium-lined cysts in the retroperitoneum similar to the lining epithelium of the fallopian tubes and the endometrium.


PURPOSE
Our goal was to characterize MR changes over time at the site of meningioma resection in order to determine optimal timing for detecting residual and recurrent tumor.

METHODS
Twenty-one patients were studied with enhanced MR imaging during the first 5 postoperative days and additional studies were obtained 3 to 8 weeks after surgery (16 studies), 3 months to 1 year after surgery (17 studies), and 1 year or more after surgery (32 studies). Images were analyzed for residual tumor, membrane enhancement, parenchymal enhancement, edema, and blood collections.

RESULTS
Early postoperative images showed extensive, thin membrane enhancement that thickened by 3 to 8 weeks after surgery and that thinned or resolved and became less extensive by 6 months or more postoperatively. Twelve of 20 patients with long-term follow-up studies had membrane enhancement. Thin, serpiginous foci of enhancement in the surgical bed were identified only on early postoperative studies and probably represent gradual thrombosis of feeding vessels.

CONCLUSION
Residual foci of meningioma are best detected on studies obtained within the first 5 days after surgery because membrane thickness increases by 3 to 8 weeks after surgery and may obscure a small residual meningioma. Our study confirms the presence of prolonged membrane enhancement after surgery, although it thins with time and becomes confined to the craniotomy site.


Objective: To investigate the risk and genetic association of oxcarbazepine-induced cutaneous adverse reactions (OXC-cADRs), including Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), in Asian populations (Chinese and Thai). Methods: We prospectively enrolled patients with OXC-cADRs in Taiwan and Thailand from 2006 to 2014, and analyzed the clinical course, latent period, drug dosage, organ involvement, complications, and mortality. We also investigated the carrier rate of HLA-B*15:02 and HLA-A*31:01 of patients with OXC-cADRs and compared to OXC-tolerant controls. The incidence of OXC-SJS/TEN was compared with carbamazepine (CBZ)–induced SJS/TEN according to the nationwide population dataset from the Taiwan National Health Insurance Research Database. Results: We enrolled 50 patients with OXC-cADRs, including 20 OXC-SJS/TEN and 6  drug reaction with eosinophilia and systemic symptoms, of Chinese patients from Taiwan and Thai patients from Thailand. OXC-cADRs presented with less clinical severity including limited skin detachment (all ≦5%) and no mortality. There was a significant association between HLA-B*15:02 and OXC-SJS (p = 1.87 × 10−10; odds ratio 27.90; 95% confidence interval [CI] 7.84–99.23) in Chinese and this significant association was also observed in Thai patients. The positive and negative predictive values of HLA-B*15:02 for OXC-SJS/TEN were 0.73% and 99.97%, respectively. HLA-A*31:01 was not associated with OXC-cADRs. The incidence and mortality of OXC-SJS/TEN was lower than CBZ-STS/TEN in new users (p = 0.003; relative risk 0.212; 95% CI 0.077–0.584). Conclusions: Our findings suggest that HLA-B*15:02 is significantly associated with OXC-SJS in Asian populations (Chinese and Thai). However, the severity and incidence of OXC-SJS/TEN are less than that of CBZ-SJS/TEN. The need for preemptive HLA-B*15:02 screening should be evaluated further.


Charles I's great warship the Sovereign of the Seas is famed for its design, decoration and importance as a tool that heightened the image of English naval supremacy. By exploring its career, size, name and decoration, this article highlights the Sovereign of the Seas' significance as a national symbol of political and cultural power. It argues that Charles's leading warship was developed as a reaction to naval advances and current affairs in Europe. Through a diverse range of evidence including diplomatic correspondence, printed texts and artwork from both English and French institutions, as well as relating this to similar advances in the Netherlands and Sweden, the Sovereign of the Seas' development is internationally contextualized. By comparing it with other contemporary warships, most importantly la Couronne of France, it is shown that Charles's flagship was a product of a growing international theatre of maritime activity that was inspired by cultural and political competition, as much as it was by military escalation.